[Transcranial magnetic stimulation as an alternative to electroshock therapy in treatment resistant depressions. A literature review].
Transcranial magnet stimulation (TMS) is a low-risk method for direct and localised stimulation of the cerebral cortex. For several years it has played an important part in measurements of the central motor conduction time (magnetically evoked potentials/MEP). Further technical and methodological developments, such as high-frequency (rapid rate TMS/rTMS) or triggered stimulation have led to broad scientific application of this method. Electric convulsive therapy (ECT) has proved its value in the treatment of various psychiatric disorders, especially in pharmaco-resistant depression. The therapeutic mechanism is actually unclear. However, the generalised convulsive fit appears to be the precondition for the therapeutic effect. A disadvantage lies in the risk inherent in the necessary general anaesthesia and the possible side effects, such as transitory states of confusion and transient mnestic deficits. Bearing in mind the possibility that TMS could have the same effects as ECT due to stimulations below the convulsion threshold or to the direct or indirect stimulations of so-called disorder-specific key regions, several pilot studies and some controlled studies have been published during the past three years on its efficacy in depressive disorders. The results were reported on and critically evaluated. The results of this survey of the literature on the subject is that (r)TMS does not represent an alternative to ECT in the therapy of pharmaco-resistant depressions. Due to its slight and only transient antidepressive effect, (r)TMS is also, in our opinion, not suitable as so-called add-on therapy as a complement to antidepressant medication.
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Klinik für Psychiatrie und Psychotherapie der Christian-Albrechts-Universität zu Kiel.
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Aldenhoff
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D003866:Depressive Disorder / Q000628:therapy*; D004351:Drug Resistance; D004574:Electromagnetic Fields; D004597:Electroshock; D006801:Humans
Die transkranielle Magnet-stimulation als Behandlungs-alternative zur Elektrokrampf-therapie bei therapieresistenten Depressionen--Eine Literaturübersicht.